Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia

Urgessa, Fekadu; Tsegaye, Aster; Gebrehiwot, Yirgu; Birhanu, Asaye

doi:10.1186/1471-2393-14-358

Cited by 12 publications

(13 citation statements)

References 19 publications

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“…5,11 Our result has shown that FMH occurs in 46% (27/59) of our participants after delivery using KBT. The test was negative in 54.24% (32/59) of patients, which was consistent with the study of Urgessa et al 16 that concluded FMH was negative in 48% (36/75) of their patients. The total volume of fetal cells in the maternal circulation is usually small and varies between 0.1 and 0.25 mL in most cases, but large volume of FMH occurs less often, with more than 15 mL of fetal red cells (approximately 30 mL whole blood) detected at a rate of 1.6% after cesarean section or complicated vaginal delivery and 0.7% after spontaneous vaginal delivery.…”

Section: Discussionsupporting

confidence: 91%

Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test

Kapadia¹,

Bansal²,

Parmar³

et al. 2016

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objectives:The aim of this article is to assess fetomaternal hemorrhage (FMH) and determine its volume and also to study the relation of the amount of FMH to various factors. Materials and methods:This was a prospective study carried out at Ahmedabad Civil Hospital from October 2012 to March 2013. A total of 75 blood samples were collected from RhDnegative mothers during the postnatal period. Sixteen samples were excluded because the fetus blood group was either Rh negative or unknown. The acid elution or Kleihauer-Betke quantitative test was used to measure the amount of FMH. The data were analyzed using Epi Info version 7.Results: With Kleihauer-Betke/acid elution test (KBT), 45.76% of women had fetal whole blood in their blood circulation during a postnatal period varying from 1.2 to 9.6 mL. The test was negative (i.e., no fetal cells were identified) in 54.24% of women. The majority of women had hemorrhage less than 4 mL. None of them had a large FMH. Conclusion:Most of the FMH calculated was <10 mL, which could have been neutralized by lower doses of anti-D immunoglobulin, which have incurred lower costs than the 300-µg dosage. Thus, developing optimized testing and accessing dosing protocols is needed in health care facilities. In the present study, we found no significant relation between the amount of FMH and parity or type of delivery.

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Section: Discussionsupporting

confidence: 91%

Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test

Kapadia¹,

Bansal²,

Parmar³

et al. 2016

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…FMH occurred in 17.9%, 10%, and 11.1% of the women at 16–24 weeks, 28–32 weeks, and 34–37 weeks of pregnancy, respectively. In previous studies, prevalence of FMH in the third trimester varied from 5.6% in Pakistan, to 40% in India, and 52% in Ethiopia . In 2 (1.3%) women, volume of FMH was greater than 30 mL, while in 30 (19.9%) women it was less than or equal to 30 mL.…”

Section: Discussionmentioning

confidence: 85%

Fetomaternal hemorrhage among pregnant women in Accra, Ghana

Akorsu

Acquaye

Benneh

et al. 2019

Intl J Gynecology & Obste

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Objective:To determine the occurrence of and risk factors for fetomaternal hemorrhage (FMH) among pregnant women at Korle Bu Teaching Hospital in Accra, Ghana. Methods:A prospective study of FMH among pregnant women without hemoglobinopathies in the second trimester attending prenatal care between October 2015 and May 2016 performed using the Kleihauer-Betke test. Volume of FMH was estimated;ABO and Rh blood groups of participants were determined. A data extraction form and structured questionnaire were used to collect demographic and clinical information, and data on risk factors. Results:Of 151 participants, 32 (21.2%) had FMH. Almost 18% (n=27) had FMH at baseline (16-24 weeks), 10% (10/100) at 28-32 weeks, and 11.1% (11/99) at 34-37 weeks of pregnancy. Volume of FMH was less than 30 mL in 30 (19.9%) women, whereas it was greater than 30 mL in 2 (1.3%) women. No identifiable patient-specific factors were associated with occurrence of FMH.Conclusion: FMH is common among pregnant women in Ghana and can occur as early as 16 weeks, without identifiable risk factors. RhD negative women who may be pregnant with RhD positive fetuses should be screened early in pregnancy, not only at delivery, for occurrence of FMH.

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“…Lo anterior permite que el operador identifique la proporción de eritrocitos fetales al interior del torrente materno, estimando mediante complejas fórmulas matemáticas la cantidad de sangre fetal (en mililitros) transfundida. 12,17,29,30 . La principal limitación del método radica en la complejidad del mismo.…”

Section: Discussionunclassified

Síndrome de Transfusión Feto-Materna. A propósito de dos casos.

Yakcich

Lambert

Marfull

et al. 2018

Rev. chil. obstet. ginecol.

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INTRODUCCIÓNEl síndrome de transfusión feto-materna (STFM), corresponde a la transferencia de sangre fetal directamente hacia la circulación materna durante el embarazo o durante el trabajo de parto. Es una patología poco frecuente; sin embargo, puede constituir una condición grave en cuyos casos más severos el feto puede sufrir anemia severa, encefalopatía hipóxico-isquémica o incluso la muerte [1][2][3][4] .Durante la gestación normal existe de manera fisiológica un grado mínimo de transfusión fetomaterna, sin llegar a constituir un evento clínicamente relevante. Esta transfusión ocurre en la mayoría de los casos sin factores de riesgo identificables, y en promedio no superaría los 15 ml de sangre, permaneciendo en su gran mayoría clínicamente asintomáticas 5,6 . Se estima que una transfusión fetomaterna sería significativa cuando supera los 30 ml de sangre. [7][8][9] . Se han propuesto niveles de 80 a 150 ml de sangre para sangrados feto maternos o transfusiones "masivas" 10 . Tomando este valor como punto de corte, se estima que la incidencia de transfusión masiva sería alrededor de 3 cada 1000 recién nacidos vivos 11,12 . Es importante destacar que las implicancias clínicas de la transfusión feto materna guardan estrecha relación con el volumen porcentual de volemia fetal transfundida. Una pérdida sanguínea fetal superior a 20 ml/Kg (25% de la volemia fetal estimada) se asocia a mayor incidencia de muerte fetal, parto prematuro, hospitalización en Unidad de Cuidados Intensivos Neonatal (UCIN) y necesidad de transfusión neonatal 11 .Dada la gravedad potencial del cuadro, es importante el diagnóstico precoz para establecer el tratamiento oportuno, el cual, dependiendo de la edad gestacional, incluye desde la transfusión fetal in útero hasta la interrupción inmediata del embarazo 5 . Una herramienta diagnóstica fundamental orientada a la detección de la anemia fetal como consecuencia de la transfusión feto-materna es la ultrasonografía doppler obstétrica, la cual permite obtener una estimación bastante precisa de la magnitud de las repercusiones fetales por la anemia secundaria. Ésta, en conjunto con otras técnicas de laboratorio, tanto cualitativas como cuantitativas, permiten verificar el diagnóstico y estimar la gravedad del cuadro. Caso Clínico 1Paciente primigesta de 30 años, RH (-) no sensibilizada, sin antecedentes mórbidos asociados. Cursando embarazo controlado de 35+3 semanas, consulta al servicio de urgencia por ausencia de movimientos fetales desde alrededor de 16 horas antes. Al interrogatorio dirigido no refiere pérdida de líquido, sangrado genital, dinámica uterina, fiebre ni otro síntoma asociado. Se realiza ecografía doppler obstétrica que muestra feto vivo, creciendo en percentil 5 para su edad gestacional según Alarcón-Pittaluga, y oligohidroamnios moderado. Doppler de arteria cerebral media no evaluado, doppler de arteria umbilical normal. Se realiza registro de la frecuencia cardíaca fetal (FCF) que resulta no reactivo, con frecuencia basal de 150 latidos por minuto,

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Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia

Cited by 12 publications

References 19 publications

Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test

Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test

Fetomaternal hemorrhage among pregnant women in Accra, Ghana

Síndrome de Transfusión Feto-Materna. A propósito de dos casos.

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